But this has nothing specific. So start guessing.
You lost 5 cognitive years from the stroke, on your own, because your doctor knows nothing and will do nothing. Guidelines don't count, they are practically useless.
Cognitive decline impairs quality of life,
threatens independence, and places more burden on an already-strained
healthcare system. Fortunately, there are interventions that help keep
the brain sharp and nimble.
Evidence-based lifestyle changes may help improve cognition and delay cognitive decline.
“Overall
research findings support positive effects of cognitive and physical
activity, social engagement, and therapeutic nutrition in optimizing
cognitive aging,” wrote the authors of a literature
review published in the
Journal of Psychosocial Nursing and Mental Health Services.
The
following are eight evidence-based lifestyle interventions that not
only stave off cognitive decline but also boost cognitive faculties.
Eat healthy fats
Proper
nutrition—in particular, lipid intake—impacts brain function and
health, which affects emotions, cognitive functions, neuroendocrine
function, behavior, and synaptic plasticity, as well as neuroprotection
or detriment.
In a meta-analysis spanning 12 randomized-controlled trials, researchers
found
that low levels of omega-3 supplementation (<1.73 g/day)
significantly reduced cognitive decline compared with placebo.
Intriguingly, the same effect was not observed with higher levels of
supplementation, so there’s probably no need to go overboard with
omega-3 intake.
From earlier research this came out: So ask your doctor to reconcile
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Omega-3s
Although taking omega-3 fatty acid supplements doesn’t seem to protect against Alzheimer’s disease or slow cognitive decline in older adults, omega-3s found in fish and other foods may offer some benefit for adults with rheumatoid arthritis.
While omega-3s have shown mixed results in patients with cardiovascular
disease (CVD), eating seafood high in omega-3s has been linked to
healthier and increased longevity in older adults.
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“The subanalysis suggests that
low-dose but not higher-dose omega-3 supplementation has positive
effects on cognitive function. This variation may in part explain the
contrasting reports observed with clinical trials of omega-3 and
cognitive function. However, what is important to note is the positive
impact of low-dose omega-3 on memory,” the researchers wrote.
“The
mechanism(s) of effect remains to be elucidated, but may include
reducing the production of amyloid beta-protein, thus reducing the
plaque burden on neuronal cells and ultimately preventing neuronal cell
death. This in turn would prevent memory loss and/or reduce the speed of
cognitive deterioration,” they concluded.
Solve puzzles (I do Ken-ken and sudoku)
Some activities that stimulate cognition can be quite fun.
“Chess
and bridge are leisure activities that demand working memory and
reasoning skills,” wrote authors of the aforementioned literature
review. “Older adults who play bridge score higher on working memory and
reasoning measures compared to nonplayers and working crossword puzzles
has also been associated with maintained cognition in older adults.”
The
authors pointed out that although most correlational studies indicated
benefits from cognitively demanding activities, more research needs to
be done to suss out whether such activities truly contribute to better
cognition.
Cultivate strong relationships(Yep, without marriage)
One
familiar adage is “happy wife, happy life.” Unfortunately, there’s no
similar saying for “happy husband.” (What rhymes with husband?)
Nevertheless, married people seem to be healthier in certain
contexts, including cognitive health.
In a systematic review and high-powered
meta-analysis published in the
Journal of Neurology, Neurosurgery & Psychiatry,
researchers compared dementia risk in married people with those who are
single, widowed, or divorced. They found that lifelong single people
had a 42% increased risk of developing dementia and widowed people had a
20% higher risk compared with married people. No associations were
observed in divorced people. Notably, decreased risk of dementia in
married people remained after considering covariates.
The
researchers had some ideas as to why married people have a lower risk
of dementia. “Being married may change individuals’ exposure to other
protective and risk factors throughout their subsequent lifespan; this
is supported by our identification of confounding factors affecting this
risk and evidence showing married people to be more likely to have a
healthy lifestyle,” they wrote.
They also
suggested the following: “Developing dementia could be related to other
underlying cognitive or personality traits meaning that in societies
where marriage was the social norm, people with difficulties in
flexibility of thought or communication and consequent smaller lifelong
cognitive reserve (therefore more likely to develop dementia) may be
less likely to marry.”
Get out and garden(Nope, just hour walks in the woods near me.)
A
growing corpus of research indicates that physical activity helps
prevent cognitive decline and Alzheimer disease. Conversely, sedentary
behavior heightens the risk of age-associated cognitive decline. In
fact,
experts estimate that a 25% reduction in sedentary behavior could prevent more than 1 million cases of Alzheimer disease globally.
In a longitudinal
study published in the
Journal of Alzheimer’s Disease, other
researchers evaluated the effect of caloric expenditure from gardening,
mowing, and raking, as well as various types of exercise, on gray
matter volumes in the elderly people with and without cognitive
impairment. “In assessing physical activity, caloric expenditure is a
proxy marker reflecting the sum total of multiple physical activity
types conducted by an individual,” they noted.
Using
MRI, the researchers found that increased gray-matter volumes in the
frontal, parietal, and temporal lobes, as well as the hippocampus,
thalamus, and basal ganglia were linked to higher caloric expenditure.
Moreover, higher levels of calorie expenditure mitigated
neurodegenerative volume loss in the precuneus, posterior cingulate, and
cerebellar vermis. In short, the more activity that older people do,
the bigger their brains.
Reduce stress(Retired, I have none.)
According to the authors of a
study published in
Science,
stress affects brain function. “Chronic stress, mainly through the
release of corticosteroids, affects executive behavior through
sequential structural modulation of brain networks. Stress-induced
deficits in spatial reference, working memory, and behavioral
flexibility are associated with synaptic and dendritic reorganization in
both the hippocampus and the medial prefrontal cortex,” they wrote.
Although there’s likely no surefire way to decrease stress, investigators publishing in the journal
Frontiers in Behavioral Neuroscience found that writing about previous failures before taking a challenging 5-minute test attenuates stress responses.
“In
a real-world setting, this information may be valuable to clinicians,
as well as educators hoping to improve attentional performance,” they
wrote. “Since writing about test anxieties has already been shown to
protect against the negative effects of stress on performance on a
high-stakes exam in a classroom setting, this writing manipulation may
be especially valuable to populations who exhibit high levels of
performance anxiety.”
Meditate(Nope, can't succeed at that, although I do think a lot on my walks.)
In
recent years, mindfulness has received a lot of attention. Mindful
meditation practices (MMP) entail giving full attention to internal and
external present-moment experiences and accepting emotional states in a
nonjudgmental manner. Sounds pretty zen, right?
In the long term, MMP facilitates executive function and attention span. But even brief interventions seem to help. In a
study published in
Consciousness and Cognition, just a few sessions of MMP improved cognition when compared with a control group.
“After
four sessions of either meditation training or listening to a recorded
book, participants with no prior meditation experience were assessed
with measures of mood, verbal fluency, visual coding, and working
memory. Both interventions were effective at improving mood but only
brief meditation training reduced fatigue, anxiety, and increased
mindfulness,” researchers wrote.
“Moreover,
brief mindfulness training significantly improved visuo-spatial
processing, working memory, and executive functioning. Our findings
suggest that 4 days of meditation training can enhance the ability to
sustain attention; benefits that have previously been reported with
long-term meditators,” they concluded.
Cut back on sugar(No clue how much I get, whatever is in the foods I eat, no juices, no sodas.)
If
the brain were a motor, then sugar could be considered its optimal
fuel. But it’s easy to overdo it with sugar, especially with its
abundance in Western diets. Excessive sugar intake is linked to both
impaired memory and dementia risk. The WHO recommends that “free sugar”
intake be limited to less than 10% of total caloric energy intake, with
cutting back below 5% linked to even more health benefits.
Per the
WHO:
“Free sugars refer to monosaccharides (such as glucose, fructose) and
disaccharides (such as sucrose or table sugar) added to foods and drinks
by the manufacturer, cook or consumer, and sugars naturally present in
honey, syrups, fruit juices and fruit juice concentrates.”
However,
this definition “does not refer to the sugars in fresh fruits and
vegetables, and sugars naturally present in milk, because there is no
reported evidence of adverse effects of consuming these sugars.”
The
WHO stresses that sugars are often “hidden” in processed foods, so
beware! For instance, 1 tablespoon of ketchup contains 4 g of free
sugars, equivalent to about 1 teaspoon. Additionally, one can of
sugar-sweetened soda may contain 40 g of sugar, a whopping 10 teaspoons!
Combine physical and cognitive exercises(Both)
In
a society that seems to focus on physical training—including cardio and
strength training—it’s easy to forget that other forms of exercise
exist. There’s also motor training, which focuses on coordination,
balance, and flexibility.
While
physical training activities are repetitive and automatic, thus
demanding high energy output but low neuromuscular input, motor training
is often the opposite (think Tai Chi). Nevertheless, there are
exceptions like tennis, which burns a lot of calories and requires thought and coordination.
In a review
article published in
Frontiers in Medicine, the author recommends a mix of both physical and motor training to boost cognition in different ways.
“In the physical training category, it is the intensity of training that enhances neuroplasticity and consequently improves cognition, while in the motor activities it is the task complexity that
increases neuroplasticity, which improves cognition. Dual-task
training, which includes cognitive demands in addition to physical or
motor activity, has proven more effective in improving cognitive
functioning than a single task,” the author wrote.
“The
implications are that if all training components traditionally
recommended by official bodies—physical as well as motor training—are
efficient in enhancing cognition, then we merely have to emphasize the
inclusion of all exercise modes in our routine exercise regimen for
physical as well as cognitive health in advanced age,” she concluded.
